The effects of action observational training on walking ability in chronic stroke patients: a double-blind randomized controlled trial

Objective: To investigate the effect of action observational training on walking ability with chronic stroke patients. Design: A double-blind randomized controlled trial. Setting: Inpatient rehabilitation hospital. Participants: Thirty chronic stroke patients. Interventions: Patients in both groups underwent treadmill training for 30 minutes. The action observational training group (n = 15) watched a video of treadmill walking actions taken at various speeds before treadmill training for 10 minutes. The control group (n = 15) watched a nature video unrelated to gait training for the same amount of time. All participants received training five times a week for a period of four weeks. Main measures: Timed up and go test, 10-metre walk test, 6-minute walk test and maximal flexed knee angle in the swing phase during walking. Results: There were significant improvements in timed up and go test (-4.47 vs. -2.47 seconds), 10-m walk test (0.35 vs. 0.16 m/s), 6-minute walk test (93.13 vs. 32.53 m) and maximal flexed knee angle in the swing phase during walking (7.11 vs. 4.58 degrees) in the action observational training group compared with the control group (P < 0.05). Small to huge effect sizes of 1.27, 0.57, 2.34 and 0.37 were observed for timed up and go test, 10-m walk test, 6-minute walk test, and maximal flexed knee angle in the swing phase during walking, respectively. Conclusion: These results suggest that action observational training is an effective method for improvement of the walking ability in chronic stroke patients.